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General NPI Number Information
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NPI Number | 1699147272
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Entity Type | Organization
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Legal Business Name | EVOKE ACUPUNCTURE
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 1101 S WINCHESTER BLVD STE L241
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City | SAN JOSE
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State | CA
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Zip | 95128-3904
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Country | US
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Telephone | 408-320-7096
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Fax | 206-309-9494
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Provider Business Mailing Address
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Address Line | 1101 S WINCHESTER BLVD STE L241
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City | SAN JOSE
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State | CA
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Zip | 95128-3904
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Country | US
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Telephone | 408-320-7096
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Fax | 206-309-9494
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Authorized Official
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Title or Position | OWNER
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Name | NEDA SALEH
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Credential | L.AC.
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Telephone | 408-320-7096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 16038
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License Number State | CA
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